By CHARLEY ROSEN

he sky might as well be blood-red, splintered bones are commonplace, and life is nothing more than a puny accident in ''Bringing Out the Dead,'' a stunning first novel by Joe Connelly. Our guide through this savage world is Frank Pierce, an emotionally exhausted paramedic working the nighttime streets of Hell's Kitchen, who divides his labors into ''good calls'' and ''bad calls.'' Sometimes Pierce is ''the reaper's reaper'' -- dispatched to rescue victims of alcohol or drug overdoses, heart seizures, car accidents, shootings, slashings or asthmatic attacks -- and he routinely effects miracles. He readily acknowledges that ''saving someone's life is . . . the best drug in the world. For days, sometimes weeks, afterward, you walk the streets making infinite whatever you see. Time slows and stretches forward and you wonder if you've become immortal, as if you saved your own life as well.'' More often, Pierce arrives at hopeless situations where his frantic efforts at resurrection are mostly useless and the victims often die in his arms. No wonder he is a fallen angel, haunted by the ghosts.

Connelly was himself a paramedic for nine years at St. Clare's Hospital in his native New York, and he is profoundly familiar with his protagonist's theater of operations. ''I have done CPR in grand ballrooms on Park Avenue and in third-floor dance halls uptown,'' Pierce says. ''On Park they stand tall black panels around you to shield the dancers from an unpleasant view, while the band keeps up their spirits with songs like 'Put On a Happy Face.' Uptown the music never breaks and the dancers' legs whirl around you like a carnival ride. I've worked on the floors of some of the finest East Side restaurants, serenaded by violins while the man at the table next to me cut into his prime rib. . . . I once brought a bartender back to life on the top of his bar while Irish dance music played. The patrons moved over for us, but no one stopped drinking.''

Like a priest who has lost his faith, Pierce is drowning in guilt and grief. Like Yossarian in ''Catch-22,'' he confuses cause and effect: he once refused to turn on the ambulance's siren because every time he did, someone died. Unable to communicate with the living, Pierce finds refuge in oblivion, revulsion and hysteria.

His wife has left him, he's begun to drink on the job, and just a month ago he botched a simple intubation procedure that ''helped to kill'' an 18-year-old asthmatic named Rose, who has become a waking nightmare symbolic of all his failures. Pierce is accustomed to ghosts. ''Rose's ghost was only the last and most visible of many who seemed to have come back solely to accuse me -- of living and knowing, of being present at their deaths, as if I had witnessed an obscene humiliation for which they could never forgive.''

Pierce is likewise haunted by a cardiac victim, Patrick Burke, who undergoes a series of heart stoppages and life-saving electric shocks. Throughout the 48 hours of the novel, Pierce imagines Burke pleading to be released into death.

As his ambulance careers from one catastrophe to another, Pierce encounters several other damaged souls: his current partner, Larry, who needs to fill his belly with food in order to sustain the belief that he is still among the living; Tom Walls, Pierce's first partner, whose particular disorder impels him to physically assault chronic overdose patients; Burke's daughter, Mary, a part-time druggie whose own overwhelming despair threatens to arouse the pity and generic longing that have replaced Pierce's capacity to love. And then there's Marcus, another veteran paramedic who, wearily accepting the invincibility of death, blithely ignores the ambulance dispatcher and will respond to only three calls every work shift.

Toward the conclusion of this otherwise searing and poignant narrative, Connelly unfortunately attempts to inflate the plot by submitting Pierce to the predatory ministrations of Cy Coates, a neighborhood drug dealer. But all this episode really accomplishes is to contrive gratuitous tie-ins with various other characters. And at times the relentless roll-call of deaths and dismemberments goes over the top. But these minor flaws are mere distractions, not fatal wounds.

As Pierce's own life ineluctably collapses while he saves the lives of others, the only wisdom he can salvage is that ''every day is Judgment Day. . . . The end is always here.'' But what propels ''Bringing Out the Dead'' is not the gruesome details, or Pierce's vivid psychological disturbance, or the thin plot, but the vigorous rhythms of Connelly's writing -- the poetry of broken bodies and broken lives, of swollen blue limbs, of green fluids seeping between shattered teeth, of dead brain cells ''exploding like sap in a fire.''